盐酸美金刚治疗放射性认知功能障碍及其与维生素联合应用的研究进展

doi:10.3760/cma.j.cn371439-20230418-00118

国际肿瘤学杂志 ›› 2023, Vol. 50 ›› Issue (10): 622-626.doi: 10.3760/cma.j.cn371439-20230418-00118

盐酸美金刚治疗放射性认知功能障碍及其与维生素联合应用的研究进展

王瑾¹, 李若阳², 赵雪巍³, 李辉⁴, 周志国⁵, 赵静霞⁶()

¹河北医科大学研究生院，石家庄 050011
²河北医科大学第四医院乳腺中心，石家庄 050011
³河北医科大学第四医院药学部，石家庄 050011
⁴河北医科大学第四医院神经外科，石家庄 050011
⁵河北医科大学第四医院放疗科，石家庄 050011
⁶河北医科大学第四医院神经内科，石家庄 050011

收稿日期:2023-04-18 修回日期:2023-07-02 出版日期:2023-10-08 发布日期:2023-11-08
通讯作者: 赵静霞 E-mail:zjxlllzh@163.com
基金资助:
河北省财政厅2020年政府资助临床优秀人才培养项目（冀财预复〔2020〕397号）

Research progress of memantine hydrochloride in the treatment of radiation-induced cognitive dysfunction and its combined application with vitamins

Wang Jin¹, Li Ruoyang², Zhao Xuewei³, Li Hui⁴, Zhou Zhiguo⁵, Zhao Jingxia⁶()

¹Graduate School of Hebei Medical University，Shijiazhuang 050011， China
²Breast Center， Fourth Hospital of Hebei Medical University， Shijiazhuang 050011， China
³Department of Pharmacy， Fourth Hospital of Hebei Medical University， Shijiazhuang 050011， China
⁴Department of Neurosurgery， Fourth Hospital of Hebei Medical University， Shijiazhuang 050011， China
⁵Department of Radiotherapy， Fourth Hospital of Hebei Medical University， Shijiazhuang 050011， China
⁶Department of Neurology， Fourth Hospital of Hebei Medical University， Shijiazhuang 050011， China

Received:2023-04-18 Revised:2023-07-02 Online:2023-10-08 Published:2023-11-08
Contact: Zhao Jingxia E-mail:zjxlllzh@163.com
Supported by:
Hebei Provincial Department of Finance 2020 Government Funded Clinical ExcellenceTraining Project（Ji Cai Yu Fu〔2020〕No. 397）

摘要/Abstract

摘要：

放射性认知功能障碍（RICD）起病隐匿，有效防治措施匮乏。盐酸美金刚作为经典治疗药物，疗效局限，寻求多靶点联合用药是必然趋势。近年来，维生素E、维生素D对认知功能的保护作用受到广泛认可。多项基础研究表明，维生素E能够通过保护神经元、降低盐酸美金刚引起的不良反应在联合用药中发挥作用；维生素D与盐酸美金刚因具有显著协同效应也已成为目前的研究热点。盐酸美金刚联合维生素治疗方案有望为RICD患者带来更多获益。

关键词: 放射疗法, 认知功能障碍, 美金刚, 维生素类

Abstract:

Radiation-induced cognitive dysfunction （RICD） has an insidious onset and there is a lack of effective prevention and treatment measures. The efficacy of memantine hydrochloride as a classical treatment drug is limited， and it is inevitable to seek multi-target combination drugs. In recent years， the protective effect of vitamin E and vitamin D on cognitive function has been widely recognized. Several basic studies have shown that vitamin E can play a role in the combination of medication by protecting neurons and reducing the adverse effects caused by memantine hydrochloride； Vitamin D and memantine hydrochloride have also become a hot topic of research due to their significant synergistic effects. The combination of memantine hydrochloride and vitamin therapy is expected to bring additional benefits to RICD patients.

Key words: Radiotherapy, Cognitive dysfunction, Memantine, Vitamins

王瑾, 李若阳, 赵雪巍, 李辉, 周志国, 赵静霞. 盐酸美金刚治疗放射性认知功能障碍及其与维生素联合应用的研究进展[J]. 国际肿瘤学杂志, 2023, 50(10): 622-626.

Wang Jin, Li Ruoyang, Zhao Xuewei, Li Hui, Zhou Zhiguo, Zhao Jingxia. Research progress of memantine hydrochloride in the treatment of radiation-induced cognitive dysfunction and its combined application with vitamins[J]. Journal of International Oncology, 2023, 50(10): 622-626.

参考文献 38

[1]	Haldbo-Classen L, Amidi A, Wu LM, et al. Long-term cognitive dysfunction after radiation therapy for primary brain tumors[J]. Acta Oncol, 2019, 58(5): 745-752. DOI: 10.1080/0284186X.2018.1557786. pmid: 30757955
[2]	Turnquist C, Harris BT, Harris CC. Radiation-induced brain injury: current concepts and therapeutic strategies targeting neuroinflammation[J]. Neurooncol Adv, 2020, 2(1): vdaa057. DOI: 10.1093/noajnl/vdaa057.
[3]	彭雯硕, 陈乃耀, 胡霞, 等. 脑部放疗引起认知功能障碍的预防和治疗[J]. 国际肿瘤学杂志, 2021, 48(1): 52-56. DOI: 10.3760/cma.j.cn371439-20200810-00010.
[4]	Scampoli C, Cammelli S, Galietta E, et al. Memantine in the prevention of radiation-induced brain damage: a narrative review[J]. Cancers (Basel), 2022, 14(11): 2736. DOI: 10.3390/cancers14112736.
[5]	Duman JG, Dinh J, Zhou W, et al. Memantine prevents acute radiation-induced toxicities at hippocampal excitatory synapses[J]. Neuro Oncol, 2018, 20(5): 655-665. DOI: 10.1093/neuonc/nox203.
[6]	Bálentová S, Adamkov M. Pathological changes in the central nervous system following exposure to ionizing radiation[J]. Physiol Res, 2020, 69(3): 389-404. DOI: 10.33549/physiolres.934309. pmid: 32469226
[7]	Moretti R, Caruso P. An iatrogenic model of brain small-vessel disease: post-radiation encephalopathy[J]. Int J Mol Sci, 2020, 21(18): 6506. DOI: 10.3390/ijms21186506.
[8]	Brown PD, Pugh S, Laack NN, et al. Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial[J]. Neuro Oncol, 2013, 15(10): 1429-1437. DOI: 10.1093/neuonc/not114.
[9]	Lynch M. Preservation of cognitive function following whole brain radiotherapy in patients with brain metastases: complications, treatments, and the emerging role of memantine[J]. J Oncol Pharm Pract, 2019, 25(3): 657-662. DOI: 10.1177/1078155218798176. pmid: 30200844
[10]	Laack NN, Pugh SL, Brown PD, et al. The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy[J]. Neurooncol Pract, 2019, 6(4): 274-282. DOI: 10.1093/nop/npy038. pmid: 31386073
[11]	Brown PD, Gondi V, Pugh S, et al. Hippocampal avoidance during whole-brain radiotherapy plus memantine for patients with brain metastases: phase Ⅲ trial NRG oncology CC001[J]. J Clin Oncol, 2020, 38(10): 1019-1029. DOI: 10.1200/JCO.19.02767. pmid: 32058845
[12]	Gondi V, Pugh SL, Mehta MP, et al. NRG oncology CC003: a randomized phase Ⅱ/Ⅲ trial of prophylactic cranial irradiation with or without hippocampal avoidance for small cell lung cancer[J]. J Clin Oncol, 2019, 37(15_suppl): TPS8578. DOI: 10.1200/JCO.2019.37.15_suppl.TPS8578.
[13]	Bhanu A, Waghmare CM, Jain VS, et al. Serum 25-hydroxy vitamin-D levels in head and neck cancer chemoradiation therapy: potential in cancer therapeutics[J/OL]. Indian J Cancer. (2023-02-27)[2023-04-10]. https://pubmed.ncbi.nlm.nih.gov/36861720/. DOI: 10.4103/ijc.IJC_358_20.
[14]	Sudmeier L, Switchenko J, Eaton B, et al. RTHP-01. Pentoxifylline and vitamin E for the treatment of radiation necrosis after stereotactic radiosurgery[J]. Neuro Oncol, 2019, 21(Supplement_6): vi210. DOI: 10.1093/neuonc/noz175.874.
[15]	Ji MT, Nie J, Nie XF, et al. 1α,25(OH)₂D₃ radiosensitizes cancer cells by activating the NADPH/ROS pathway[J]. Front Pharmacol, 2020, 11: 945. DOI: 10.3389/fphar.2020.00945.
[16]	Chen PT, Hsieh CC, Chen MF. Role of vitamin D₃ in tumor aggressiveness and radiation response for hepatocellular carcinoma[J]. Mol Carcinog, 2022, 61(8): 787-796. DOI: 10.1002/mc.23421.
[17]	Gu YH, Kang KM, Yamashita T, et al. Effects of vitamin E on the immune system and tumor growth during radiotherapy[J]. J Cancer Res Ther, 2021, 17(1): 211-217. DOI: 10.4103/jcrt.JCRT_706_18.
[18]	Jung AY, Cai X, Thoene K, et al. Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy[J]. Am J Clin Nutr, 2019, 109(1): 69-78. DOI: 10.1093/ajcn/nqy223. pmid: 30668630
[19]	Day NL, Carle MS, Floyd CL. Post-injury administration of a combination of memantine and 17β-estradiol is protective in a rat model of traumatic brain injury[J]. Neurochem Int, 2017, 111: 57-68. DOI: 10.1016/j.neuint.2017.04.018. pmid: 28472639
[20]	Lamprecht MR, Morrison B 3rd. A combination therapy of 17β-estradiol and memantine is more neuroprotective than monotherapies in an organotypic brain slice culture model of traumatic brain injury[J]. J Neurotrauma, 2015, 32(17): 1361-1368. DOI: 10.1089/neu.2015.3912.
[21]	Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial[J]. JAMA, 2014, 311(1): 33-44. DOI: 10.1001/jama.2013.282834. pmid: 24381967
[22]	Annweiler C, Brugg B, Peyrin JM, et al. Combination of memantine and vitamin D prevents axon degeneration induced by amyloid-β and glutamate[J]. Neurobiol Aging, 2014, 35(2): 331-335. DOI: 10.1016/j.neurobiolaging.2013.07.029. pmid: 24011542
[23]	Broberg DN, Wong D, Bellyou M, et al. Effects of memantine and high dose vitamin D on gait in male APP/PS1 Alzheimer's disease mice following vitamin D deprivation[J]. J Alzheimers Dis, 2022, 85(4): 1755-1766. DOI: 10.3233/JAD-215188.
[24]	Zamani N, Moazedi AA. The effects of co-administration of memantine and vitamin D on spatial learning and memory impairment in adult male rats model of Alzheimer's disease[J]. J Arak Univ Med Sci, 2020, 22(6): 192-203. DOI: 10.32598/jams.22.6.5166.2.
[25]	Wong D, Broberg DN, Doad J, et al. Effect of memantine treatment and combination with vitamin D supplementation on body composition in the APP/PS1 mouse model of Alzheimer's disease following chronic vitamin D deficiency[J]. J Alzheimers Dis, 2021, 81(1): 375-388. DOI: 10.3233/JAD-201137.
[26]	Lemire P, Brangier A, Beaudenon M, et al. Cognitive changes under memantine according to vitamin D status in Alzheimer patients: an exposed/unexposed cohort pilot study[J]. J Steroid Biochem Mol Biol, 2018, 175: 151-156. DOI: 10.1016/j.jsbmb.2016.12.019.
[27]	Annweiler C, Herrmann FR, Fantino B, et al. Effectiveness of the combination of memantine plus vitamin D on cognition in patients with Alzheimer disease: a pre-post pilot study[J]. Cogn Behav Neurol, 2012, 25(3): 121-127. DOI: 10.1097/WNN.0b013e31826df647. pmid: 22960436
[28]	Lecoq AL, Livrozet M, Blanchard A, et al. Drug-related hypercalcemia[J]. Endocrinol Metab Clin North Am, 2021, 50(4): 743-752. DOI: 10.1016/j.ecl.2021.08.001.
[29]	Aqeel F, Del Castillo J, Jaar BG, et al. Hypercalcemia, acute kidney injury, and metabolic alkalosis[J]. Case Rep Nephrol, 2022, 2022: 1320259. DOI: 10.1155/2022/1320259.
[30]	Barth K, Sedivy M, Lindner G, et al. Successful treatment with denosumab for two cases with hypercalcemia due to vitamin D intoxication and associated acute kidney injury[J]. CEN Case Rep, 2022, 11(1): 141-145. DOI: 10.1007/s13730-021-00643-5.
[31]	Jia J, Hu J, Huo X, et al. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer's disease: a randomised, double-blind, placebo-controlled trial[J]. J Neurol Neurosurg Psychiatry, 2019, 90(12): 1347-1352. DOI: 10.1136/jnnp-2018-320199. pmid: 31296588
[32]	Schietzel S, Fischer K, Brugger P, et al. Effect of 2 000 IU compared with 800 IU vitamin D on cognitive performance among adults age 60 years and older: a randomized controlled trial[J]. Am J Clin Nutr, 2019, 110(1): 246-253. DOI: 10.1093/ajcn/nqz081. pmid: 31152541
[33]	Castle M, Fiedler N, Pop LC, et al. Three doses of vitamin D and cognitive outcomes in older women: a double-blind randomized controlled trial[J]. J Gerontol A Biol Sci Med Sci, 2020, 75(5): 835-842. DOI: 10.1093/gerona/glz041.
[34]	Mohammad LG. Two immigrant children with vitamin D poisoning[J]. Ugeskr Laeger, 2018, 180(26): V12170921.
[35]	Zajac IT, Barnes M, Cavuoto P, et al. The effects of vitamin D-enriched mushrooms and vitamin D₃ on cognitive performance and mood in healthy elderly adults: a randomised, double-blinded, placebo-controlled trial[J]. Nutrients, 2020, 12(12): 3847. DOI: 10.3390/nu12123847.
[36]	Kang JH, Vyas CM, Okereke OI, et al. Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial[J]. Sci Rep, 2021, 11(1): 23253. DOI: 10.1038/s41598-021-02485-8. pmid: 34853363
[37]	Mäkitie A, Tuokkola I, Laurell G, et al. Vitamin D in head and neck cancer: a systematic review[J]. Curr Oncol Rep, 2020, 23(1): 5. DOI: 10.1007/s11912-020-00996-7. pmid: 33216252
[38]	Liang L, Yu W, Cai B, et al. Determination of multiple vitamins in 178 patients undergoing chemotherapy for lung cancer[J/OL]. Arch Med Sci. (2021-01-11)[2023-04-10]. https://doi.org/10.5114/aoms/130302. DOI: 10.5114/aoms/130302.

盐酸美金刚治疗放射性认知功能障碍及其与维生素联合应用的研究进展

Research progress of memantine hydrochloride in the treatment of radiation-induced cognitive dysfunction and its combined application with vitamins

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 38

相关文章 15

编辑推荐

Metrics

本文评价

[1]	高凡, 王萍, 杜超, 褚衍六. 肠道菌群与结直肠癌非手术治疗的相关研究进展[J]. 国际肿瘤学杂志, 2024, 51(6): 376-381.
[2]	李书月, 马辰莺, 周菊英, 徐晓婷, 秦颂兵. 寡转移非小细胞肺癌的放疗进展[J]. 国际肿瘤学杂志, 2024, 51(3): 170-174.
[3]	李济时, 陆钊群, 刘俊茹, 吕建勋, 陈霜, 沈琳, 徐志渊, 吴平安. 新辅助放疗联合部分喉切除术治疗喉滑膜肉瘤1例并文献复习[J]. 国际肿瘤学杂志, 2024, 51(2): 123-125.
[4]	中国医师协会放射肿瘤治疗医师分会, 中华医学会放射肿瘤治疗学分会, 中国抗癌协会肿瘤放射治疗专业委员会. 中国食管癌放射治疗指南（2023年版）[J]. 国际肿瘤学杂志, 2024, 51(1): 1-20.
[5]	高新雨, 李振江, 孙洪福, 韩丹, 赵倩, 刘成新, 黄伟. 基于MR加速器的MR引导放疗在食管癌患者中的临床应用[J]. 国际肿瘤学杂志, 2024, 51(1): 37-42.
[6]	崔腾璐, 吕璐, 孙鹏飞. 放疗联合免疫治疗在头颈部鳞状细胞癌治疗中的应用[J]. 国际肿瘤学杂志, 2023, 50(9): 548-552.
[7]	李青珊, 谢鑫, 张楠, 刘帅. 放疗联合系统治疗在乳腺癌中的应用进展[J]. 国际肿瘤学杂志, 2023, 50(6): 362-367.
[8]	许萌, 姜伟, 朱海涛, 曹雄锋. 癌相关成纤维细胞在肿瘤放疗抵抗中的研究进展[J]. 国际肿瘤学杂志, 2023, 50(4): 227-230.
[9]	石小琪, 汪红艳. 肠道菌群与放射性肠炎的相互作用及研究进展[J]. 国际肿瘤学杂志, 2023, 50(4): 244-247.
[10]	李进芝, 赵彪, 文晓博, 张明, 袁美芳, 孙梦真, 蒲琴, 杨毅. Monaco系统计算网格尺寸对T₄期鼻咽癌的剂量学影响[J]. 国际肿瘤学杂志, 2023, 50(11): 641-649.
[11]	耿睿, 马俊强, 郭强, 牛钊峰. 老年乳腺癌患者的综合治疗方式选择倾向及其影响因素[J]. 国际肿瘤学杂志, 2023, 50(11): 650-654.
[12]	王冰, 王爱馥, 刘雯舒, 范娇娇, 田伟成, 王玮莉, 刘博宇. 重组人血小板生成素治疗肿瘤放疗所致血小板减少症的疗效及安全性[J]. 国际肿瘤学杂志, 2023, 50(11): 661-667.
[13]	中国医师协会放射肿瘤治疗医师分会, 中华医学会放射肿瘤治疗学分会, 中国抗癌协会肿瘤放射治疗专业委员会. 新型冠状病毒感染疫情背景下肿瘤患者放射治疗管理相关问题中国专家共识（2023版）[J]. 国际肿瘤学杂志, 2023, 50(10): 577-584.
[14]	许婷婷, 胡超苏, 李宝生. 抗EGFR单抗治疗局部晚期头颈部鳞状细胞癌临床共识（2023年版）[J]. 国际肿瘤学杂志, 2023, 50(1): 1-11.
[15]	刘佳, 葛小林, 狄晓珂, 史玉静, 曾玉婷. 喜炎平注射液预防放射性食管炎的疗效分析[J]. 国际肿瘤学杂志, 2022, 49(3): 146-150.